Clinical Revenue Integrity Specialist

2 weeks ago


Chesapeake, Virginia, United States TEKsystems Full time

Unlock your potential in a remote clinical revenue integrity role with TEKsystems.

About the Role:

We're seeking a highly skilled Clinical Revenue Integrity Specialist to join our team. As a key member of our operations, you'll play a vital role in ensuring accurate and efficient revenue capture for our clients.

Responsibilities:

  • Perform audits of itemized charges versus patient medical records and other applicable documentation
  • Assign modifiers to appropriate claims, researching edited claims for medical necessity and advising billing staff on HCPCS codes and modifiers
  • Collaborate with revenue-producing departments to resolve lost charges, billing queries, coding, and charge capture issues, providing CDM support as needed
  • Review observation accounts for carve-out observation hours, extended recovery, ED visit, injection, and infusion charges
  • Process requests for chart audits, prepare reports for finance and claims departments, and provide educational efforts for provider services, claims, recovery, and finance staff
  • Analyze audit results, trending hospital or provider audits, and provide feedback and process improvement recommendations
  • Communicate effectively with clinical and non-clinical staff and individuals, both verbally and in writing

Requirements:

  • CPC certification or equivalent
  • 5+ years of hospital coding experience
  • RN or LPN with charge entry experience
  • Nurse auditing experience is a plus

What We Offer:

  • $40.00 - $42.00 per hour
  • A range of benefits including medical, dental, and vision coverage, critical illness and accident insurance, 401(k) retirement plan, life insurance, short and long-term disability, health spending account, transportation benefits, employee assistance program, and time off/leave options

About Us:

TEKsystems is an Allegis Group company and an equal opportunity employer. We welcome applications from diverse candidates and are committed to creating an inclusive environment. Apply now to take the next step in your career



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